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Tall cell papillary thyroid cancer: incidence and prognosis
J H Terry1, S A St John, F J Karkowski
1Department of Surgery, Brooklyn Hospital Center, New York, New York 10012.
Background:
The tall cell variant (TCV) of papillary thyroid cancer is reported to have a poor prognosis. This study examines the incidence and end result of surgical treatment of TCV.
Methods:
In this study, 240 thyroid cancers treated over a 23-year period at two hospital centers are reviewed. A total of 153 patients with papillary cancer were available for follow-up. All microscopic slides were re-examined.
Results:
Of the total 183 papillary cancers, 19 (10.4%) were TCV. The remainder were usual papillary or other papillary cancer variants. Patient age, tumor size, lymph node and soft-tissue involvement, recurrence, and death rates were evaluated. Multivariate statistical analysis disclosed that TCV histology, as well as age and tumor size, were significant predictors of recurrence.
Conclusion:
Despite a high rate of recurrence in TCV cases over age 50 (6/9), there were no recurrent TCVs in cases under age 50 (0/8). Pathologists and surgeons must develop an increased awareness of this entity and implications for more radical treatment in the older age group.